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Individual

KRAIG NIEWOHNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
435 CAMDEN RD, MOUNT STERLING, IL 62353-1058
(217) 773-3377
(217) 773-3255
Mailing address
550 FRONTAGE RD, SUITE 2415, NORTHFIELD, IL 60093-1202
(847) 441-5593
(847) 441-0734

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004062
IL

Other

Enumeration date
06/08/2010
Last updated
06/08/2010
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